胃促生長素對胃大部切除大鼠術后早期恢復的影響_《中國普外基礎與臨床雜志》

作者：

于嵩 , 王志剛 , 楊成廣 , 閻鈞 , 鄭起

上海交通大學附屬第六人民醫院普外科（上海 200233）;

關鍵詞：

胃促生長素胃大部切除大鼠吻合口羥脯氨酸

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目的探討應用外源性胃促生長素（ghrelin）對胃大部切除術后大鼠早期恢復的影響。方法將12只胃大部切除（畢Ⅰ式）大鼠隨機均分為2組，分別于腹腔內注射生理鹽水或胃促生長素，稱量術前和術后1～7 d的大鼠體重和每日攝食量；術后第7天處死大鼠，實時熒光定量PCR法測定大鼠胃底組織中胃促生長素mRNA表達相對量，并檢測吻合口爆破壓和吻合口組織中羥脯氨酸含量。結果2組大鼠之間術前及術后1～7 d體重的差異均無統計學意義（P＞0.05）。生理鹽水組大鼠體重術后逐漸降低，并均明顯低于術前（P lt;0.01），且在術后第5天達到最低（P lt;0.01），后逐漸增加，但仍均低于術前（P lt;0.01）；胃促生長素組大鼠體重術后逐漸降低，除術后1 d與術前比較的差異無統計學意義（P=0.693）外，均明顯低于術前（P lt;0.01），在術后第4天達到最低（P lt;0.01），后逐漸增加，但仍均低于術前（P lt;0.05或P lt;0.01）。胃促生長素組大鼠的累積攝食量為（52.50±6.77） g，明顯高于生理鹽水組大鼠的(45.67±7.47) g，P lt;0.05。術后第7天胃促生長素組大鼠胃底組織中胃促生長素mRNA表達相對量為0.08±0.04，明顯低于生理鹽水組大鼠的0.22±0.07（P lt;0.01）。胃促生長素組大鼠吻合口爆破壓為（172.33±10.44） mm Hg（1 mm Hg=0.133 kPa），明顯高于生理鹽水組的(155.83±6.62) mm Hg，P lt;0.05。胃促生長素組大鼠吻合口組織中羥脯氨酸含量為（0.50±0.29）μg/mg wet tissue，明顯高于生理鹽水組大鼠的(0.43±0.05) μg/mg wet tissue，P lt;0.01。結論胃促生長素能有效促進胃大部切除術后大鼠的早期恢復，而外源性胃促生長素的攝入可抑制機體術后早期的負反饋性代償作用。

引用本文： 于嵩,王志剛,楊成廣,閻鈞,鄭起. 胃促生長素對胃大部切除大鼠術后早期恢復的影響. 中國普外基礎與臨床雜志, 2011, 18(7): 728-731. doi: 復制

1.	Kojima M, Hosoda H, Date Y, et al. Ghrelin is a growthhormonereleasing acylated peptide from stomach [J]. Nature, 1999, 402(6762): 656660.
2.	Ueno H, Yamaguchi H, Kangawa K, et al. Ghrelin: a gastric peptide that regulates food intake and energy homeostasis [J]. Regul Pept, 2005, 126(12): 1119.
3.	Date Y, Murakami N, Toshinai K, et al. The role of the gastric afferent vagal nerve in ghrelininduced feeding and growth hormone secretion in rats [J]. Gastroenterology, 2002, 123(4): 11201128.
4.	王維剛, 王志剛, 張永彥, 等. 生長激素促分泌素受體基因敲除小鼠胚胎干細胞的建立 [J]. 中國普外基礎與臨床雜志, 2008, 15(10): 733738.
5.	Kojima M, Kangawa K. Ghrelin: structure and function [J]. Physiol Rev, 2005, 85(2): 495522.
6.	Kojima M, Kangawa K. Ghrelin: more than endogenous growth hormone secretagogue [J]. Ann N Y Acad Sci, 2010, 1200(1): 140148.
7.	Kiyama T, Mizutani T, Okuda T, et al. Postoperative changes in body composition after gastrectomy [J]. J Gastrointest Surg, 2005, 9(3): 313319.
8.	蘇丹, 蘭平, 任東林, 等. 小承氣合劑促進結腸吻合術后吻合口組織愈合的實驗研究 [J]. 中國普外基礎與臨床雜志, 2011, 18(1): 3942.
9.	Livak KJ, Schmittgen TD. Analysis of relative gene expression data using realtime quantitative PCR and the 2Delta Delta CT Method [J]. Methods, 2001, 25(4): 402408.
10.	Schefe JH, Lehmann KE, Buschmann IR, et al. Quantitative realtime RTPCR data analysis: current concepts and the novel “gene expression’s CT difference” formula [J]. J Mol Med, 2006, 84(11): 901910.
11.	Cowley MA, Smith RG, Diano S, et al. The distribution and mechanism of action of ghrelin in the CNS demonstrates a novel hypothalamic circuit regulating energy homeostasis [J]. Neuron, 2003, 37(4): 649661.
12.	Toshinai K, Date Y, Murakami N, et al. Ghrelininduced food intake is mediated via the orexin pathway [J]. Endocrinology, 2003, 144(4): 15061512.
13.	Tschp M, Smiley DL, Heiman ML. Ghrelin induces adiposity in rodents [J]. Nature, 2000, 407(6806): 908913.
14.	Wren AM, Small CJ, Abbott CR, et al. Ghrelin causes hyperphagia and obesity in rats [J]. Diabetes, 2001, 50(11): 25402547.
15.	Wang HT, Lu QC, Wang Q, et al. Role of the duodenum in regulation of plasma ghrelin levels and body mass index after subtotal gastrectomy [J]. World J Gastroenterol, 2008, 14(15): 24252429.
16.	Cummings DE, Weigle DS, Frayo RS, et al. Plasma ghrelin levels after dietinduced weight loss or gastric bypass surgery [J]. N Engl J Med, 2002, 346(21): 16231630.
17.	Dornonville de la Cour C, Bjrkqvist M, Sandvik AK, et al. Alike cells in the rat stomach contain ghrelin and do not operate under gastrin control [J]. Regul Pept, 2001, 99(23): 141150.
18.	Dornonville de la Cour C, Lindqvist A, Egecioglu E, et al. Ghrelin treatment reverses the reduction in weight gain and body fat in gastrectomised mice [J]. Gut, 2005, 54(7): 907913.
19.	Takachi K, Doki Y, Ishikawa O, et al. Postoperative ghrelin levels and delayed recovery from body weight loss after distal or total gastrectomy [J]. J Surg Res, 2006, 130(1): 17.
20.	de Hingh IH, Siemonsma MA, de Man BM, et al. The matrix metalloproteinase inhibitor BB94 improves the strength of intestinal anastomoses in the rat [J]. Int J Colorectal Dis, 2002, 17(5): 348354.
21.	李占武, 王利, 李方毅, 等. 局部緩釋血管內皮生長因子促進腸吻合口愈合的研究 [J]. 中國普外基礎與臨床雜志, 2010, 17(11): 11411146.
22.	Lanfranco F, Motta G, Baldi M, et al. Ghrelin and anterior pituitary function [J]. Front Horm Res, 2010, 38: 206211.
23.	Hataya Y, Akamizu T, Takaya K, et al. A low dose of ghrelin stimulates growth hormone (GH) release synergistically with GHreleasing hormone in humans [J]. J Clin Endocrinol Metab, 2001, 86(9): 4552.
24.	Dixit VD, Schaffer EM, Pyle RS, et al. Ghrelin inhibits leptin and activationinduced proinflammatory cytokine expression by human monocytes and T cells [J]. J Clin Invest, 2004, 114(1): 5766.
25.	De Smet B, Thijs T, Moechars D, et al. Endogenous and exogenous ghrelin enhance the colonic and gastric manifestations of dextran sodium sulphateinduced colitis in mice [J]. Neurogastroenterol Motil, 2009, 21(1): 5970.
26.	Brzozowski T, Konturek PC, Sliwowski Z, et al. Prostaglandin/cyclooxygenase pathway in ghrelininduced gastroprotection against ischemiareperfusion injury [J]. J Pharmacol Exp Ther, 2006, 319(1): 477487.
27.	Konturek PC, Brzozowski T, Konturek SJ, et al. Role of histamine in ghrelininduced gastroprotection against acute gastric lesions [J]. Inflamm Res, 2007, 56 Suppl 1: S25S26.

1. Kojima M, Hosoda H, Date Y, et al. Ghrelin is a growthhormonereleasing acylated peptide from stomach [J]. Nature, 1999, 402(6762): 656660.
2. Ueno H, Yamaguchi H, Kangawa K, et al. Ghrelin: a gastric peptide that regulates food intake and energy homeostasis [J]. Regul Pept, 2005, 126(12): 1119.
3. Date Y, Murakami N, Toshinai K, et al. The role of the gastric afferent vagal nerve in ghrelininduced feeding and growth hormone secretion in rats [J]. Gastroenterology, 2002, 123(4): 11201128.
4. 王維剛, 王志剛, 張永彥, 等. 生長激素促分泌素受體基因敲除小鼠胚胎干細胞的建立 [J]. 中國普外基礎與臨床雜志, 2008, 15(10): 733738.
5. Kojima M, Kangawa K. Ghrelin: structure and function [J]. Physiol Rev, 2005, 85(2): 495522.
6. Kojima M, Kangawa K. Ghrelin: more than endogenous growth hormone secretagogue [J]. Ann N Y Acad Sci, 2010, 1200(1): 140148.
7. Kiyama T, Mizutani T, Okuda T, et al. Postoperative changes in body composition after gastrectomy [J]. J Gastrointest Surg, 2005, 9(3): 313319.
8. 蘇丹, 蘭平, 任東林, 等. 小承氣合劑促進結腸吻合術后吻合口組織愈合的實驗研究 [J]. 中國普外基礎與臨床雜志, 2011, 18(1): 3942.
9. Livak KJ, Schmittgen TD. Analysis of relative gene expression data using realtime quantitative PCR and the 2Delta Delta CT Method [J]. Methods, 2001, 25(4): 402408.
10. Schefe JH, Lehmann KE, Buschmann IR, et al. Quantitative realtime RTPCR data analysis: current concepts and the novel “gene expression’s CT difference” formula [J]. J Mol Med, 2006, 84(11): 901910.
11. Cowley MA, Smith RG, Diano S, et al. The distribution and mechanism of action of ghrelin in the CNS demonstrates a novel hypothalamic circuit regulating energy homeostasis [J]. Neuron, 2003, 37(4): 649661.
12. Toshinai K, Date Y, Murakami N, et al. Ghrelininduced food intake is mediated via the orexin pathway [J]. Endocrinology, 2003, 144(4): 15061512.
13. Tschp M, Smiley DL, Heiman ML. Ghrelin induces adiposity in rodents [J]. Nature, 2000, 407(6806): 908913.
14. Wren AM, Small CJ, Abbott CR, et al. Ghrelin causes hyperphagia and obesity in rats [J]. Diabetes, 2001, 50(11): 25402547.
15. Wang HT, Lu QC, Wang Q, et al. Role of the duodenum in regulation of plasma ghrelin levels and body mass index after subtotal gastrectomy [J]. World J Gastroenterol, 2008, 14(15): 24252429.
16. Cummings DE, Weigle DS, Frayo RS, et al. Plasma ghrelin levels after dietinduced weight loss or gastric bypass surgery [J]. N Engl J Med, 2002, 346(21): 16231630.
17. Dornonville de la Cour C, Bjrkqvist M, Sandvik AK, et al. Alike cells in the rat stomach contain ghrelin and do not operate under gastrin control [J]. Regul Pept, 2001, 99(23): 141150.
18. Dornonville de la Cour C, Lindqvist A, Egecioglu E, et al. Ghrelin treatment reverses the reduction in weight gain and body fat in gastrectomised mice [J]. Gut, 2005, 54(7): 907913.
19. Takachi K, Doki Y, Ishikawa O, et al. Postoperative ghrelin levels and delayed recovery from body weight loss after distal or total gastrectomy [J]. J Surg Res, 2006, 130(1): 17.
20. de Hingh IH, Siemonsma MA, de Man BM, et al. The matrix metalloproteinase inhibitor BB94 improves the strength of intestinal anastomoses in the rat [J]. Int J Colorectal Dis, 2002, 17(5): 348354.
21. 李占武, 王利, 李方毅, 等. 局部緩釋血管內皮生長因子促進腸吻合口愈合的研究 [J]. 中國普外基礎與臨床雜志, 2010, 17(11): 11411146.
22. Lanfranco F, Motta G, Baldi M, et al. Ghrelin and anterior pituitary function [J]. Front Horm Res, 2010, 38: 206211.
23. Hataya Y, Akamizu T, Takaya K, et al. A low dose of ghrelin stimulates growth hormone (GH) release synergistically with GHreleasing hormone in humans [J]. J Clin Endocrinol Metab, 2001, 86(9): 4552.
24. Dixit VD, Schaffer EM, Pyle RS, et al. Ghrelin inhibits leptin and activationinduced proinflammatory cytokine expression by human monocytes and T cells [J]. J Clin Invest, 2004, 114(1): 5766.
25. De Smet B, Thijs T, Moechars D, et al. Endogenous and exogenous ghrelin enhance the colonic and gastric manifestations of dextran sodium sulphateinduced colitis in mice [J]. Neurogastroenterol Motil, 2009, 21(1): 5970.
26. Brzozowski T, Konturek PC, Sliwowski Z, et al. Prostaglandin/cyclooxygenase pathway in ghrelininduced gastroprotection against ischemiareperfusion injury [J]. J Pharmacol Exp Ther, 2006, 319(1): 477487.
27. Konturek PC, Brzozowski T, Konturek SJ, et al. Role of histamine in ghrelininduced gastroprotection against acute gastric lesions [J]. Inflamm Res, 2007, 56 Suppl 1: S25S26.

《中國普外基礎與臨床雜志》

胃促生長素對胃大部切除大鼠術后早期恢復的影響

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《中國普外基礎與臨床雜志》

胃促生長素對胃大部切除大鼠術后早期恢復的影響

摘要 全文 圖表 視頻 參考文獻 施引文獻 補充材料

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